Incidence of, and potential risk factors for, postoperative gastrointestinal dysfunction (POGD) after gastrointestinal procedures performed in US hospitals were examined. This retrospective study used hospital discharge data of inpatients who underwent ≥1 gastrointestinal procedures from 1-Jan-2016 to 30-Apr-2019. POGD incidence was calculated based on all hospitalizations for MDC-06 procedures. Predictors of POGD were assessed using multivariable logistic regression. POGD incidence was 5.8% among 638 611 inpatient hospitalizations. Major bowel procedures, peritoneal adhesiolysis, and appendectomy were the most notable predictors of POGD among gastrointestinal procedures assessed (adjusted odds ratios 95% confidence intervals: 2.71 2.59–2.83, 2.48 2.34–2.64, and 2.15 2.03–2.27, respectively; all p < 0.05). Procedures performed by colorectal/gastroenterology specialists (0.86 0.84–0.89), and those performed percutaneously (0.55 0.54–0.56) were associated with significantly lower odds of POGD (both P < 0.05). Findings may help clinicians tailor management plans targeting patients at high-risk of POGD. •The incidence of POGD among 638 611 hospitalizations for GI procedures was 5.8%.•Major bowel procedures, adhesiolysis, and appendectomy were predictors of POGD.•Lower risk of POGD with colorectal/gastroenterology specialist involvement.•Procedures performed percutaneously were associated with lower odds of POGD.